Should I be honest with my doctor about my pot use?June 1, 2012 8:33 AMSubscribe

Should I be honest with my doctor about my pot use?

On Monday, I have an appointment for a physical for the first time in my adult life (I'm 29). I have never met this doctor before. In the interest of getting the best care possible, I'd like to be honest with him about my regular marijuana use, but before doing so I wanted to get a sense of what the implications are of this.

Is he obligated to report this to my insurance company? Is he allowed to, even if not obligated? Are there other consequences I'm not considering? Is it just a bad idea, or is pot commonplace enough now that I shouldn't worry so much about it?

As a lawyer, I often read people's medical records who are plaintiffs in lawsuits. Statements to doctors such as the one you describe are often written down by doctors and exist in your medical records pretty much forever. With the push to make medical records electronic (which has been fully adopted by systems such as Kaiser), these statements are increasingly documented in digital format (that is, typed rather than scrawled), and are thus easy readable (and findable via text searching). In addition to the review of medical records in the event of a lawsuit, medical records may be required to be provided in other contexts, such as in an application for insurance coverage, or as part of a pre-employment review or clearance for certain safety-sensitive or security-sensitive employment positions.posted by ClaudiaCenter at 8:45 AM on June 1, 2012 [24 favorites]

There is no upside. Make yourself aware of the medical benefits / effects / hazards of smoking pot, and filter his advice through that. Keep it to yourself for the many good reasons above.posted by Meatbomb at 8:47 AM on June 1, 2012 [5 favorites]

Unless you have a close relationship with your doctor and an established way of speaking off-record, there's no reason to. Most of the time, if you're experiencing something that smoking could be causing or exacerbating -- mainly psychological issues, but also lung/chest stuff -- the doctor's first piece advice will be to stop smoking.posted by griphus at 8:53 AM on June 1, 2012

From my layperson perspective, the only time you should inform your doctor about that is if you're being prescribed medication or are being diagnosed for ailments that may have a relation. For a standard meet and greet physical, you might just be setting yourself up for a lecture and a permanent notation in your file with no real upside.posted by Burhanistan at 8:57 AM on June 1, 2012 [1 favorite]

Do not disclose*. A friend of mine's dumbass parents told his doctor that he was smoking pot heavily (he really wasn't that heavy of a smoker) in an effort to bring about an 'intervention' (ugh). It went on his medical records and now he has a hard time getting insurance. He's currently uninsured but if he wanted to be, his rates would be through the roof.

Don't tell your doctor. I am legal in MI and I refrain from disclosing this to my doctor. Nothing good can come from it. As said above, once it is in your file, its there. Also consider the following, 1.) While a patient can have access to their medical records, Dr's do not have to disclose mental/drug abuse notes to patients and 2.) Being labeled a drug abuser/seeker can really hurt you down the road.posted by handbanana at 9:11 AM on June 1, 2012 [2 favorites]

why not? My personal take is that pot is somewhere between mildly to insanely therapeutic. (at least for me). I don't think it's wise to allow prevailing stigma to distract us from the fact that marijuana has immense medicinal value. Unless your doctor knows your wife or parents and you don't want the cat out of the bag, it's best to tell the truth. Then again, your doctor is probably a dogma machine like most people and he'll tell you it's bad and to quit. But if you smoke, be true to your intuition. If you smoke too much, cut down. Otherwise, it can only help you steer clear from the grabbag of societal insanity that plagues most us. Pot is good.posted by halatukit at 9:12 AM on June 1, 2012 [1 favorite]

>I don't think it's wise to allow prevailing stigma to distract us from the fact that marijuana has immense medicinal value.

While this is ideologically noble, it's unreasonable to expect ordinary citizens to take up that kind of banner, unless you're also going to point them in the direction of monetary assistance in the event their insurance rates go up.posted by Burhanistan at 9:14 AM on June 1, 2012 [18 favorites]

When my (Kaiser) doctor originally asked me if I smoked, drank or used drugs, I answered and now, some 26 years later, I see those same answers on every printout of every office visit that I have with that facility even if it's unrelated to what I'm currently being treated for. Tread carefully, because, as everyone except halatukit has said, your answers will be entered into your medical record and insurers have access to those records.posted by Lynsey at 9:18 AM on June 1, 2012 [5 favorites]

I would not disclose anything like that in a routine physical. The last time I was at the ENT, he had laryngoscope up my nose to go down my throat, and he sort of idly asked me if I'd ever done drugs. I was just like "why are you asking me to lie to you?" and we left it at that.posted by elizardbits at 9:23 AM on June 1, 2012 [6 favorites]

My doctor is also my partner's and she is fully aware that he smokes pot. The trust factor was already there since he has been seeing her for years, so I felt comfortable disclosing. Since I have issues with anxiety, I thought it would be useful for her to know.

Big difference: I'm in Canada. I just posed this question to a couple of expat American friends and their answer was "HELL NO. Deny deny deny."posted by futureisunwritten at 9:27 AM on June 1, 2012 [1 favorite]

I'm in Canada as well and I dont think disclosing is a problem at all, so I guess it depends on your location.posted by whalebreath at 9:33 AM on June 1, 2012 [1 favorite]

In Canada, I would admit it (theoretically, anyhow, as I have actually never smoked pot). When I was in the US, I would never, ever have even considered admitting that I occasionally had alcohol (less than once a week, not more than two drinks at a time, and I was legal, but it was at my school and no). I would especially not admit it to a doctor I did not already have an ongoing relationship with.

You can reconsider once you know the doctor, but start off saying no.posted by jeather at 9:54 AM on June 1, 2012

I personally would tell a doctor if the use is regular, especially if I was on a prescription or had any sort of mental health issues. But I come from Australia originally and from everyones reactions on here I am assuming things are not so rosy in the US in regard to pot smoking so proceed with caution.posted by wwax at 10:03 AM on June 1, 2012

Another Canadian thinking this isn't a big deal at all, and most people I know disclose to their doctors. But we don't have to worry about getting denied health care, so YMMV.posted by Jairus at 10:12 AM on June 1, 2012

I have a very good relationship with my doctor. Years ago, when I had a chronic thing going on, I told him that I smoked pot between pain med doses to keep from having to take so damn many pills (and to alleviate the associated nausea). He said that's totally fine, but that I should never tell a doctor that because most will write it in my records. I asked if he was going to record it, and he said, point-blank, "Hell no. I like you." That's all I needed to hear. I would never mention it to another doctor.posted by heyho at 10:13 AM on June 1, 2012 [3 favorites]

No way. My wife and I are reluctant to even tell doctors about valid medical problems, or anything really. It’s amazing what can come back to haunt you with insurance companies. We’ve had very minor things mentioned in a visit used as a reason to not let us switch plans, etc.

Until we get a real medical system in the U.S. (assuming you’re in the U.S.) I keep everything on a need to know basis. Sad but true.posted by bongo_x at 10:14 AM on June 1, 2012

Anon mentions in the question that he/she lives "in a state where pot is decriminalized but not yet legal" and also mentions possible insurance issues so I think we can assume this is not in Canada.posted by miskatonic at 10:14 AM on June 1, 2012

No you should not. Medical records are permanent; They also can be used for life insurance and other such things. This will be permanent. Hospitals are stupid, they will assume your smoking pot 30 years from now. Removing things from records is nearly impossible.posted by couchdive at 10:22 AM on June 1, 2012 [1 favorite]

I don't smoke, and I'm generally anti-pot, and I think it's a bad idea to tell your doctor.

In Pennsylvania, you can lose your driver's license if your doctor decides to tell the appropriate authorities about your use of alcohol. It's not that great a leap to see that happening with pot use.

I'd only mention it if I had some reason to think it was truly going to be medically relevant.

In response to a standard check-the-box-yes-or-no question? Hell no, I wouldn't say a damn thing. But if (hypothetically) you had some sort of weird throat infection / breathing problem / unexplained illness, or really if anything was wrong with you, then you'd certainly want to disclose everything.

Doctors hate it when patients basically second-guess questions or filter information out of what they're reporting, but given the current medical/legal/insurance regime in the U.S., it's unreasonable to expect anyone not to.posted by Kadin2048 at 11:01 AM on June 1, 2012

Some additional info - I'm reading up on the disclosure policies specifically for my (US-based) provider (Oxford), and there is an awful lot of info that they say they are permitted to disclose to various authorities without my express permission, depending on my state of residence, including: prescriptions; general health info; communicable diseases; STDs; genetic information; HIV/AIDS; &c. States in which they are allowed to "use and disclose alcohol and drug abuse information (1) under certain limited circumstances, and/or disclose only (2) to specific recipients" are CT, GA, HI, KY, IL, IN, IA, LA, NC, NH, WA, WI.

I have no idea what the deal is with other providers, but considering the general uniformity of the US health care industry, I think it's safe to assume that most other plans have similar policies, and whatever applies for one state with one provider will likely apply for all providers.

I also have no idea what it means if a state is not included in that listing - I guess it could mean that the non-listed states have specific laws against that kind of disclosure, or that the non-listed states have no laws either for or against, or that the non-listed states allow for much less restricted disclosure of such information.posted by elizardbits at 11:12 AM on June 1, 2012

I don't even tell the truth in the family history questionnaire to protect my health insurance. Lie, lie, lie.

Although apparently no one believes you when you say you don't drink at all, so they will 'interpret' those answers if you try to say you have no bad habits at all.posted by winna at 4:01 PM on June 1, 2012 [1 favorite]

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